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MEDI5752 in Combination With Carboplatin Plus Pemetrexed in Unresectable Pleural Mesothelioma

Phase 3
Recruiting
Conditions
Unresectable Pleural Mesothelioma
Interventions
Registration Number
NCT06097728
Lead Sponsor
AstraZeneca
Brief Summary

This is a phase III, randomized, open-label, multicenter, global study to determine the efficacy and safety of Volrustomig (MEDI5752) + Carboplatin + Pemetrexed vs the investigator's choice of platinum + Pemetrexed or Nivolumab + Ipilimumab in participants with unresectable pleural mesothelioma.

Detailed Description

Adult patients with histologically proven diagnosis of pleural mesothelioma with advanced unresectable disease are eligible to be enrolled. Patients will be randomized 1:1 to receive Volrustomig (MEDI5752) + Carboplatin + Pemetrexed or the investigator's choice of platinum+Pemetrexed or Nivolumab+Ipilimumab, based on their histology.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
600
Inclusion Criteria
  • Participant must be ≥ 18 years at the time of screening
  • Histologically proven diagnosis of pleural mesothelioma with known histology (epithelioid vs. non-epithelioid)
  • Advanced unresectable disease that cannot be treated with curative surgery (with or without chemotherapy)
  • WHO/ECOG performance status of 0 or 1 with no deterioration (that is, ECOG PS>1) over the previous 2 weeks prior to day of first dosing
  • Has measurable disease per modified RECIST1.1
  • Has adequate bone marrow reserve and organ function at baseline

Key

Exclusion Criteria
  • As judged by the investigator, any condition that would interfere with evaluation of the investigational product or interpretation of participant safety or study results.
  • Active or prior documented autoimmune or inflammatory disorders
  • History of another primary malignancy with exceptions.
  • Uncontrolled intercurrent illness
  • Tuberculosis, hepatitis B (HBV) or hepatitis C (HCV), human immunodeficiency virus (HIV) infection that is not well controlled
  • Any concurrent chemotherapy, radiotherapy, investigational, biologic, or hormonal therapy for cancer treatment
  • Untreated or progressive CNS metastatic disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Volrustomig + Carboplatin + pemetrexedVolrustomigVolrustomig in combination with carboplatin plus pemetrexed
Volrustomig + Carboplatin + pemetrexedPemetrexedVolrustomig in combination with carboplatin plus pemetrexed
Investigator's choice of standard careIpilimumabThe investigator's choice of nivolumab plus ipilimumab or platinum plus pemetrexed chemotherapy for participants with epithelioid histology, and nivolumab plus ipilumab for participants with non-epithelioid histology.
Volrustomig + Carboplatin + pemetrexedCarboplatinVolrustomig in combination with carboplatin plus pemetrexed
Investigator's choice of standard carePemetrexedThe investigator's choice of nivolumab plus ipilimumab or platinum plus pemetrexed chemotherapy for participants with epithelioid histology, and nivolumab plus ipilumab for participants with non-epithelioid histology.
Investigator's choice of standard careCarboplatinThe investigator's choice of nivolumab plus ipilimumab or platinum plus pemetrexed chemotherapy for participants with epithelioid histology, and nivolumab plus ipilumab for participants with non-epithelioid histology.
Investigator's choice of standard careCisplatinThe investigator's choice of nivolumab plus ipilimumab or platinum plus pemetrexed chemotherapy for participants with epithelioid histology, and nivolumab plus ipilumab for participants with non-epithelioid histology.
Investigator's choice of standard careNivolumabThe investigator's choice of nivolumab plus ipilimumab or platinum plus pemetrexed chemotherapy for participants with epithelioid histology, and nivolumab plus ipilumab for participants with non-epithelioid histology.
Primary Outcome Measures
NameTimeMethod
Overall Survival (OS) in experimental arm relative to comparator armup to approximately 52 months

OS is defined as the time from randomization until the date of death due to any cause.

Secondary Outcome Measures
NameTimeMethod
Landmark OS12, 18, 24, 36 months

Landmarks of OS12, OS18, OS24, and OS36.

Landmark PFS6, 12, 18, 24 months

Landmarks of PFS6, PFS12, PFS18, and PFS24

PFS2up to approximately 52 months

PFS2 defined as the time from randomization to the earliest of the progression event (following the initial investigator-assessed progression), after first subsequent therapy, or death.

Maximum plasma concentration of the drug (Cmax)Up to approximately 52 months

The concentration of MEDI5752 in serum will be determined (Cmax will be derived).

Patient-reported HRQoL (Health-related Quality of Life) using EORTC QLQ-C30 HRQoL subscale (IL305 Q7-8)Up to approximately 52 months

Change from baseline in functioning will be assessed by the following measure:

HRQoL: EORTC (European Organisation For Research And Treatment Of Cancer) QLQ (Quality of Life Questionnaire) -C30 HRQoL subscale (IL305 Q7-8) (Item Library 305). The questions are from a scale of 1 (very poor) to 7 (excellent). The higher the score the higher the HRQoL.

Overall Survival (OS)up to approximately 52 months

OS is defined as the time from randomization until the date of death due to any cause.

Duration of Response (DoR)up to approximately 52 months

DoR defined as the time from the date of first documented response until date of documented progression per mRECIST 1.1 and/or RECIST 1.1 as assessed by the investigator at local site or death due to any cause.

Patient-reported physical functioningup to approximately 52 months.

TTD in physical functioning as measured by PROMIS (Patient Reported Outcomes Measurement Information System) Physical Function Short Form 8c. There are 8 questions each from a scale of 1 (unable to do) to a scale of 5 (With a little difficulty). The higher the scores the better the patient-reported physical functioning is.

Disease-related symptoms using PRO-CTCAE (Q1, 5, 6, 9)Up to approximately 52 months

Change from baseline in disease-related symptoms as measured by individual symptom items from the PRO-CTCAE (Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events) (Q1, 5, 6, 9). PRO-CTCAE responses are scored from 0 to 4 (or 0/1 for absent/present). The higher the score the higher the disease-related symptoms.

Patient-reported role functioning using EORTC QLQ-C30 RF subscale (IL305 Q2 3)up to approximately 52 months

Change from baseline in functioning will be assessed by the following measure:

Role functioning: EORTC (European Organisation For Research And Treatment Of Cancer) QLQ (Quality of Life Questionnaire) -C30 RF (Role Functioning) subscale (IL305 Q2 3) (Item Library 305). The questions are from a scale of 1 (not at all) to 4 (very much). The lower the score the higher the patient-reported role functioning is.

Immunogenicity of volrustomigup to approximately 52 months

Incidence of Anti-Drug Antibodies against volrustomig.

Overall Response Rate (ORR)up to approximately 52 months

Proportion of participants who have a confirmed Complete Response or confirmed Partial Response, as determined by the investigator at local site per mRECIST 1.1 and/or RECIST 1.1.

The time taken to reach the maximum concentration (Tmax)Up to approximately 52 months

The concentration of MEDI5752 in serum will be determined (Tmax will be derived).

Progression Free Survival (PFS)up to approximately 52 months

PFS is defined as the time from randomization until progression per mRECIST 1.1 and/or RECIST 1.1 as assessed by the investigator at local site, or death due to any cause.

Disease-related symptoms using EORTC IL305 (Q1)Up to approximately 52 months.

Change from baseline in disease-related symptoms as measured by individual symptom items from the EORTC (European Organisation For Research And Treatment Of Cancer) IL305 (Item Library 305) (Q1). It is scored from a 1 (not at all) to a 4 (very much). The higher the score the higher the disease-related symptoms.

Area under the curve (AUC)Up to approximately 52 months

The concentration of MEDI5752 in serum will be determined. Area under the curve is the integral of the concentration-time curve. The AUC reflects the actual body exposure to drug after administration. The AUC is dependent on the rate of elimination of the drug from the body and the dose administered.

Incidence of Adverse Events (AEs) AEs graded by CTCAE version 5.0Up to approximately 52 months

Incidence of Adverse Events (AEs) AEs graded by CTCAE (Common Terminology Criteria for Adverse Events) version 5.0. Grade refers to the severity of the AE. The CTCAE displays grade 1 (mild) through 5 (death related to AE). Grade 2 (moderate), Grade 3 (Severe) and Grade 4 (Life-threatening consequences).

Trial Locations

Locations (1)

Research Site

🇬🇧

Taunton, United Kingdom

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